Agenda 07/14/2020 Item #16D13 (Resolution - Transportation Plan for State Fiscal Year 2020-2023)07/14/2020
EXECUTIVE SUMMARY
Recommendation to adopt a Resolution approving the transportation plan for acute care services
for adults and children in Collier County for the state fiscal year 2020-2023.
OBJECTIVE: To implement an integrated and coordinated transportation plan for adults and children
under the Baker Act or Marchman Act.
CONSIDERATIONS: During the 2016 State of Florida Legislative Session Senate Bill 12 was passed,
requiring communities to develop a coordinated transportation plan to serve those suffering from acute
substance abuse and mental health issues, particularly for those persons involuntarily committed under the
Baker Act, F.S. 394, Part 1 Florida Mental Health Act or Marchman Act, Florida Statute 397 Hal S.
Marchman Alcohol or Other Drug Services Act of 1993. The intent of the legislation was for
communities to develop a plan that provides safe and well-coordinated transportation to the nearest
designated receiving facility. Collier County Board of County Commissioners (Board) adopted the pr ior
2017-2020 plan at the April 25, 2017 Board meeting (Agenda Item #16D6). The plan expired in June
2020; however, an extension was granted for ninety (90) days by the Florida Department of Children and
Families due to COIVD-19.
Collier County is part of the Department of Children and Families Suncoast Region. The transportation
plan was developed by community stakeholders, who include but are not limited to the City of Naples,
Collier County Sheriff, Collier County EMS, National Alliance for Mental Illness, David Lawrence
Center, and are also known as the Community Behavioral Health Advisory Committee (CBHAC). The
agencies and organizations involved in this plan include Collier County Sheriff and other law
enforcement agencies as applicable, David Lawrence Center, Naples Community Hospital, Physician
Regional Medical Center, and other treatment facilities as applicable. The plan specifically addresses:
1. Method of transportation within the designated receiving facility system for those requiring involunt ary
commitment.
2. Specialized transportation for patients to and among receiving facilities and to treatment centers.
3. Specify the manner in which persons will be transported to, from, and between facilities, including
transportation of those persons unable to pay for the cost of transportation pursuant to s. 394.462(2).
4. Describe those arrangements made by the facilities tailored to meet the needs of those persons with
unique special needs such as those with visual or hearing impairments and/or the el derly with physical
frailties.
The cost of the transportation will be incurred by the Collier County Sheriff’s office and other law
enforcement agencies, and Collier EMS for those persons with an acute medical condition or the
treatment facility post-admission to another facility.
This plan requires the approval of the Board, the Managing Entity for Substance Abuse and Mental
Health, Central Florida Behavioral Healthcare Network (CFBHC), and the Florida Department of
Children and Families. This plan is a policy document and does require acknowledgment and
participation on behalf of Collier County.
Approval of this Item will satisfy and serve the legislative intent and shall be known as the Collier County
Transportation Plan.
FISCAL IMPACT: The proposed action described in this Executive Summary has no Fiscal impact.
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GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
Executive Summary.
LEGAL CONSIDERATIONS: This Item has been approved as to form and legality and requires
majority vote for approval -JAB
RECOMMENDATION: To adopt a Resolution approving the Collier County Transportation Plan 2020-
2023.
Prepared By: Christin Plummer, Grant Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. Transportation Plan 2020 (PDF)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.13
Doc ID: 12702
Item Summary: Recommendation to adopt a Resolution approving the transportation plan for
acute care services for adults and children in Collier County for the state fiscal year 2020-2023.
Meeting Date: 07/14/2020
Prepared by:
Title: – Community & Human Services
Name: Christin Plummer
06/17/2020 2:00 PM
Submitted by:
Title: Manager - Federal/State Grants Operation – Community & Human Services
Name: Kristi Sonntag
06/17/2020 2:00 PM
Approved By:
Review:
Community & Human Services Tami Bailey Additional Reviewer Completed 06/19/2020 12:27 PM
Community & Human Services Kristi Sonntag CHS Review Completed 06/23/2020 5:01 PM
Operations & Veteran Services Kimberley Grant Level 1 Reviewer Completed 06/24/2020 1:05 PM
Public Services Department Todd Henry Level 1 Division Reviewer Completed 06/24/2020 3:11 PM
Grants Erica Robinson Level 2 Grants Review Completed 06/24/2020 4:07 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 06/25/2020 8:36 AM
Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 06/25/2020 3:35 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 06/25/2020 4:00 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 06/25/2020 4:11 PM
Budget and Management Office Ed Finn Additional Reviewer Completed 06/29/2020 11:08 AM
Grants Therese Stanley Additional Reviewer Completed 06/29/2020 1:12 PM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 07/07/2020 10:37 AM
Board of County Commissioners MaryJo Brock Meeting Pending 07/14/2020 9:00 AM
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Introduction
In accordance with Florida Statute Chapter 394, Patt I, Florida Mental Health Act or the "Baker Act",
Florida Statute Chapter 397, Hal S. Marchman Alcohol and Other Drug Services Act of l 993, and
Senate Bill 12, a plan has been developed to organize a centralized approach for access to acute care
services, and to describe how the community shall suppott and facilitate safe and well-coordinated
transpmtation to the nearest receiving facility system. This plan has been developed by community
stakeholders, as described herein, and referred to as the Collier County Community Behavioral
Health Advisory Committee (CBHAC). This transportation plan requires approval by the Collier
County Board of County Commissioners, Central Florida Behavioral Health Network (CFBHN), and
the Department of Children and Families (DCF). Upon approval, this document will serve as the
transportation plan for Collier County per legislative intent and be referred to as the Collier County
Transportation Plan (CCTP).
The Collier County Transportation plan will:
I.Describe methods of transport to a facility within the designated receiving system for
individuals subject to involuntary examination under s. 394.463 or involuntary
admission under s. 397.6772, s. 397.679, s. 397.6798, or s. 397.681 l.
2.Describe the commitment to ensuring a specialized transpottation system that provides an
efficient and humane method oftranspotting patients to receiving facilities, among receiving
facilities, and to treatment facilities.
3.Describe arrangements by which a facility may provide, in addition to required psychiatric and
addiction services, an environment and services which are uniquely tailored to the needs of an
identified group of persons with special needs, such as persons with hearing impairments or
visual impairments, or elderly persons with physical frailties;
4.Specify how persons shall be transported to, from, or between participating facilities when
necessary and agreed to, including persons unable to pay the expense of transportation,
pursuant to s. 394.462(2).
The plan, along with an accurate inventory of designated receiving facilities and related public
resources to provide care for persons in need of behavioral health acute care services, shall be
maintained and available to law enforcement and to first responders, per s. 394.4573(2)(b).
Purpose
In the continued best interest of persons in need of public behavioral healthcare in Collier County, it is
agreed that this plan will continue the successful established Baker Act/Marchman Act transportation
system, known as the Collier County Transportation Plan. The Plan will ensure that individuals on an
involuntary Baker Act/Marchman Act will obtain immediate access to acute care services and will reduce
the need for inter-hospital transfers for psychiatric and addiction services. Coordination of services among
providers in Collier County will meet the individualized needs of persons experiencing a behavioral
health/substance use crisis, with timely access to care.
The Plan calls for all law enforcement agencies in Collier County to transpott:
I.Adults and youth on an involuntary Baker Act to the David Lawrence Center's Emergency
Services Assessment Center (ESAC).
2.Adults on an involuntary Marchman Act to Collier County Jail Center.
3.Youth under the age of 18 years on an involuntary Marchman Act to the nearest local hospital
emergency room.
The following objectives are expected to be met by establishing this Transpottation Plan for Collier
County:
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•Implement an integrated and coordinated system of transportation and access to psychiatric
services for children and adults under a Baker Act order and appropriate and available
substance use services for adults or children under a Marchman Act order for Collier County
•Provide specialized services to children and the elderly.•Assist law enforcement in the efficient transport of individuals in need of services to the most
appropriate facility.•Enhance the ability to fully utilize the capacity of acute care services in the county and reduce
the unnecessary delay of transfers between facilities.
•Ensure timely access to care, continuity of care, and provide integrated and client-centered
coordination of care among providers.
Community Behavioral Health Advisory Committee: The purpose of the Community Behavioral
Health Care Advisoty Committee is to discuss the operations of the Collier County Transportation Plan
and to establish ongoing communication for the implementation of best practices and quality behavioral
health services via a community collaborative approach. The committee meets regularly to discuss
grievances, public satisfaction, and assurance of patient rights as related to this plan. The Community
Behavioral Health Care Advisory Committee is composed of, but not limited to, representatives of the
following agencies:
•Central Florida Behavioral Health Network
•City of Naples Police Depmtment•Collier County Emergency Medical Services.•Collier County Sheriffs Office•CPE Mobile Crisis Response Team
•David Lawrence Centers•Department of Children and Families Substance Abuse and Mental Health office•Florida Department of Corrections•Hazelden-Betty Ford Foundation-Naples
•Marco Island Police Department•National Alliance on Mental Illness•NCH Healthcare System•Park Royal Hospital•Physicians Regional Medical Center
•Riverside Behavioral Health Center•The Willough of Naples
System Capacity •David Lawrence Centers (DLC), located at 6075 Bathey Lane, Naples, FL is a public receiving
facility licensed by the Agency for Health Care Administration (AHCA) to operate 30 Crisis
Stabilization Unit beds for adults and minors. DLC also operates a 12-bed adult substance use
detox facility, and 18 adult substance use residential beds. At all times, DLC will maintain the
current number of publicly funded beds serving the needs of Collier County residents.
•NCH Healthcare System (NCH) and Physicians Regional Medical Center (PRMC) are not
receiving facilities, but are responsible to evaluate, treat and transfer persons in need of mental
health and addiction treatment as pait of their emergency departments. This is in accordance with
federal Emergency Medical Treatment and Labor Act (EMTALA) emergency care rules and the
medical treatment aspect of the plan applies to NCH and PRMC.
•The receiving facilities within the County, and in nearby sister counties will notify the
Community Behavioral Health Advisory Committee of any changes in system capacity.
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•Overflow: The David Lawrence Center (DLC) CSU is licensed by the Agency for Health Care
Administration for a specified number of beds for adults and children. At no time will the David
Lawrence Center's census status prevent the acceptance of a law enforcement Baker Act. DLC
and local community hospitals will follow Florida Statutes and EMT ALA regulations regarding
the care of individuals at the hospital who are under the Baker Act when a bed is not available at
the CSU.
Baker Act Transportation •Law enforcement agencies in Collier County will remain the responsible parties to transport those
individuals in need of mental health services under the Baker Act to the nearest receiving facility.
Transportation to, from, or between facilities may be required due to several factors, including
medical necessity, inpatient acute care capacity, or individual choice. The receiving facility, and
the facility that the person is being transported to or from shall coordinate these transp01tation
arrangements.
•If an individual has a medical issue that needs to be addressed or an intoxication level that is
medically compromising, Emergency Medical Services are required to transport the individualbeing detained under a Baker Act order to the nearest emergency care center for medical
stabilization. When the individual has been stabilized and has been accepted by the Baker Act
receiving facility, the Baker Act receiving facility will notify law enforcement to transp01t the
individual to the receiving facility as outlined below.
Once an individual has been medically cleared by the hospital and accepted by the receiving
facility: •Individuals under the Baker Act will be transported to the Bathey Lane campus of David
Lawrence Center by the Collier County Sheriff's Office, unless an active felony criminal charge
is present, which requires transfer to the Collier County Jail (see Criminal Charges section
below).•Adults under the Baker Act who are medically stabilized and who have Medicare insurance will
be offered transfer to the nearest Medicare-receiving facility ( e.g., Park Royal Hospital or
Riverside Behavioral Hospital) utilizing contracted transp01tation services such as Ambitrans or
Medicab, or via DLC staff transportation.
Medical Treatment
The Community Behavioral Health Advisory Committee will review medical exclusionary guidelines for
the receiving facility that will be used to assist in determining the most appropriate inpatient setting for
psychiatric patients requiring hospitalization. These guidelines will be shared among all the community
partners to ensure that individuals who are assessed to need medical care are treated in an emergency care
center or medical facility.
When medically necessary, persons are treated for high-risk physical health care conditions either at an emergency department or appropriate health care facility (either NCH Health Care System or Physicians
Regional Medical Center). In the event a person arrives at an emergency room, it is the expectation that
the hospital will abide by federal Medicare Guidelines Section 1867, (COBRA) Examination and Treatment for Emergency Medical Conditions and Women in Labor (EMT ALA) to screen, examine,
stabilize, treat and transfer individuals appropriately. In turn, the designated receiving system shall work
with the emergency depattment to coordinate the ongoing care of the individual, whether it is an
outpatient discharge or referral or inpatient treatment.
Criminal Charges:
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Interorganizational Collaboration
Implementing an effective Transportation Plan on behalf of persons in need of behavioral health services
requires a significant amount of cooperation, commit ment and collaboration from all parties involved.
Besides having the strong support of law enforcement and the behavioral health providers, Collier County
hospitals have engaged in a public planning process which has strengthened the relationships between all
parties responsible for implementing the Transpo1tation Plan in Collier County.
Index of Attachments to Collier Connty Transportation Plan
A.Definitions
B.Acute Care Services Overview
C.David Lawrence Mental Health Center, Inc. Cettificate of Liability Insurance (Note:
Certificate will be attached with final PDF version. Includes minimum of$100,000 as
specified in Checklist.)
D.Collier County Sheriff's Office MOU/Transpottation Plan
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Acute Care Services
A.INTRODUCTION
Attachment B
David Lawrence Mental Health Center, Inc., d.b.a. David Lawrence Centers, is a private, not-for
profit community mental health center whose primary mission is to provide a wide range of mental
health, alcohol and substance abuse services to meet the needs of the citizens of Collier County.
David Lawrence Centers' mission is restoring and rebuilding lives by providing compassionate,
advanced, and exceptional mental health, substance use, and integrated healthcare solutions,
available to all. The vision of the David Lawrence Centers is to lead the way in transformational
care so every individual assisted can achieve what is possible. David Lawrence Centers' Board of
Directors and management staff are committed to a planning and performance improvement
process consistent with the overall mission of the agency.
Emergency Services Assessment Center (ESAC) is staffed with Emergency Service (ES) clinicians
who are available to provide clinical triage services for emergency referrals. Services include Crisis
Assessment, Risk Assessment, Crisis Intervention, Crisis Suppmt referral for Urgent Care Services
or other appropriate service(s) within or outside the agency, and/or referral for admission to an
appro priate Acute Care Unit. The Emergency Services Assessment team works collaboratively
with the Acute Care team, where ongoing clinical triage/assessment occurs off hours and on
weekends. The ESAC serves as the Collier County Baker Act receiving facility.
The Adult Crisis Stabilization Unit (CSU) is a 19-bed, locked, non-hospital inpatient mental health
unit that provides brief voluntary and involuntary evaluation and stabilization treatment services
for individuals experiencing a psychiatric crisis who meet the criteria defined under the Florida
Mental Health Act.
The Children's Crisis Stabilization Unit (CCSU) is an I I-bed, locked, non-hospital inpatient
mental health unit, which provides brief voluntary and involuntary evaluation and stabilization
services for children who are in a psychiatric crisis.
B.REFERRAL SERVICES
Emergency Services Assessment Center, Adult & Children's Crisis Stabilization Unit: Referrals to the Emergency Services Assessment Center (ESAC) include self-refen-als,
professionals within or outside of the David Lawrence Center and/or law enforcement. Individuals
may access walk-in crisis services 24 hours a day, seven days a week. ESAC provides telephone
triage and crisis intervention outside the normal business hours and during regular business hours.
Baker Act admissions and law enforcement cases are received 24/7.
Involuntary admission to the CSU may be through appropriate professionals, law enforcement or
ex-patte court orders, identified in the Florida Mental Health Act (Baker Act). The Crisis
Stabilization Units serve any person who without care or treatment of a mental illness, may cause
harm to his/herself or others as evidenced by recent behavior or who, without care or treatment, is
likely to suffer from neglect, refuse to care for his/herself, or pose a real and present threat of
substantial harm to personal well-being. Individuals admitted will be determined to meet the Baker
Act criteria, as per the Florida Mental Health Act (Ch. 394). Individuals may be admitted under
voluntary or involuntary status.
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._! -Public Services Department
Community & Human Services Division
June 2, 2020
Melissa Leslie, LMHC
Regional Substance Abuse & Mental Health Director
Florida Department of Children and Families, SunCoast Region
9393 N. Florida Ave, Tampa, Fl 33612
Re: Collier County Baker Act and Marchman Act Transportation Plan Renewal
Dear Ms. Leslie,
We are requesting an extension for the renewal of the Collier County Transportation Plan. Due to the
unexpected factors related to the COVID-19 pandemic, Collier County has experienced delays in the
process to update the Transportation Plan. Collier County Board of County Commissioners was unable to
convene within the time constraints of the plan renewal deadline. Collier County will present the
renewal to the Board no later than August 2020.
If you have questions or comments, please contact me at (239) 252-2486
Respectfully,
Digilally signed by S t K · t' SanntagKrisli onn ag ns I Date: 2020.06.03 16:44:16 -04'00'
Kristi Sonntag
Director
Collier County Community and Human Services
------<i>·------
Com munily & Human Services Divis ion• 3339 Tamiami Trail East, S uite 2 11 • Naples, Florida 34112-5361
239-252-CARE (2273) • 239-252-CAFt (2233) • 239-252-4230 (RSVP)• www.colliergov.net/humanservices
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Parties of Agreement for COLLIER COUNTY
TRANSPORTATION PLAN
2020-2023
Acknowledgment Form
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